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Racial Diagnostic Bias of Schizophrenia Explored

J Abnorm Psychol; ePub 2019 Feb 14; Schwartz, et al

African Americans are 2.4 times more likely to be diagnosed with a schizophrenia-spectrum diagnosis compared with whites, who are more likely to receive an affective diagnosis, according to a recent study. The study investigated bias-driven diagnostic disparities between African Americans and whites, by using traditional symptom rating scales, clinical diagnoses, and objective, behaviorally based measures. Data was aggregated from 3 separate studies conducted on outpatients (n=251) with schizophrenia-spectrum or affective disorders. Researchers used computationally derived acoustic markers of speech to tap hallmark negative symptoms (eg, blunted affect or alogia) and behavioral-based markers of language failures to tap disorganization. Clinician symptom ratings were made using the Brief Psychiatric Rating Scale. They found:

  • Results confirmed the diagnostic bias between African Americans and whites though there were no differences on clinician symptom ratings.
  • On the other hand, the computerized and behavioral measures revealed more speech disorder and less blunted affect in African Americans vs whites.
  • Moderation analysis suggests that behaviorally based measures impact the relationship between race and diagnosis; however, this was largely unsupported for race and clinical symptom ratings.


Schwartz EK, Docherty NM, Najolia GM, Cohen AS. Exploring the racial diagnostic bias of schizophrenia using behavioral and clinical-based measures. [Published online ahead of print February 14, 2019]. J Abnorm Psychol. doi:10.1037/abn0000409.